Yin Xiaorui, Tang Na, Fan Xuhui, Wang Shengping, Zhang Junhai, Gu Jianjun, Wang Han
Department of Radiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Radiology, Shanghai Cancer Center, Fudan University, Shanghai, China.
Eur Radiol. 2023 Feb;33(2):1465-1474. doi: 10.1007/s00330-022-09118-2. Epub 2022 Sep 8.
MR imaging-guided focused ultrasound surgery (MRgFUS) is an emerging non-invasive treatment. It is helpful in investigating the mid-term grading efficacy and safety of MRgFUS, and possible risk factors in participants with painful bone metastases.
This four-center prospective study enrolled 96 participants between June 2016 and May 2019 with painful bone metastases. The Numerical Rating Scale (NRS), Brief Pain Inventory-Quality of Life (BPI-QoL) score, morphine equivalent daily dose (MEDD), and the adverse events (AEs) were recorded before and at 1 week, 1 month, 2 months, and 3 months after MRgFUS. The repeated ANOVA tests were used to analyze the change in NRS and BPI-QoL, and logistic regression analysis was used to analyze the possible risk factors.
A total of 82 participants completed the 3-month follow-up period. And 16 (19.5%) participants were complete responders (CR), 46 (56.1%) participants were effective responders (ER), and the other 20 (24.4%) participants were non-responders (NR). The NRS (2.67 ± 2.47 at 3 months compared to 6.38 ± 1.70 before treatment) and BPI-QoL score (3.11 ± 2.51 at 3 months compared to 5.40 ± 1.85 before treatment) significantly decreased after the treatment at all time points (p < 0.001). Eleven adverse events were recorded and they were all cured within 1 to 52 days after treatment. The non-perfused volume (NPV) ratio (p = 0.001) and the bone metastases lesion type (p = 0.025) were the key risk factors.
MRgFUS can be used as a non-invasive, effective, and safe modality to treat painful bone metastases. NPV ratio and the lesion type may be used as affecting factors to predict the mid-term efficacy of MRgFUS.
• MRgFUS can be considered a non-invasive, effective, and safe modality to treat painful bone metastases. • The NRS and BPI-QoL score at 1 week, 1 month, 2 months, and 3 months all decreased significantly (p < 0.001) after receiving MRgFUS. Among 82 participants, 16 (19.5%) were complete responders, 46 (56.1%) were effective responders, and the other 20 (24.4%) were non-responders. • According to logistic regression analysis, non-perfused volume ratio and the bone metastases lesion type were the affecting factors to predict the mid-term efficacy of MRgFUS. The adjusted OR of non-perfused volume ratio was 0.86 (p = 0.001), and osteoblastic lesion type was 0.06 (p = 0.025).
磁共振成像引导聚焦超声手术（MRgFUS）是一种新兴的非侵入性治疗方法。有助于研究MRgFUS治疗疼痛性骨转移患者的中期疗效和安全性以及可能的风险因素。
这项四中心前瞻性研究在2016年6月至2019年5月期间纳入了96例伴有疼痛性骨转移的患者。在MRgFUS治疗前以及治疗后1周、1个月、2个月和3个月记录数字评分量表（NRS）、简明疼痛量表-生活质量（BPI-QoL）评分、吗啡等效日剂量（MEDD）以及不良事件（AE）。采用重复方差分析检验分析NRS和BPI-QoL的变化，采用逻辑回归分析分析可能的风险因素。
共有82例患者完成了3个月的随访期。16例（19.5%）患者为完全缓解者（CR），46例（56.1%）患者为有效缓解者（ER），另外20例（24.4%）患者为无反应者（NR）。所有时间点治疗后NRS（治疗前为6.38±1.70，3个月时为2.67±2.47）和BPI-QoL评分（治疗前为5.40±1.85，3个月时为3.11±2.51）均显著降低（p<0.001）。记录到11例不良事件，均在治疗后1至52天内治愈。非灌注体积（NPV）比（p=0.001）和骨转移瘤类型（p=0.025）是关键风险因素。
MRgFUS可作为一种治疗疼痛性骨转移的非侵入性、有效且安全的方法。NPV比和病变类型可作为预测MRgFUS中期疗效的影响因素。
•MRgFUS可被视为一种治疗疼痛性骨转移的非侵入性、有效且安全的方法。•接受MRgFUS治疗后，1周、1个月、2个月和3个月时的NRS和BPI-QoL评分均显著降低（p<0.001）。82例患者中，16例（19.5%）为完全缓解者，46例（56.1%）为有效缓解者，另外20例（24.4%）为无反应者。•根据逻辑回归分析，非灌注体积比和骨转移瘤类型是预测MRgFUS中期疗效的影响因素。非灌注体积比的调整后OR为0.86（p=0.001），成骨型病变类型为0.06（p=0.025）。
